Depression: Symptoms, Treatments, and Tips for Living with Depression
If you read the previous article, you've learned more about depression and its causes. You probably also have a better understanding of the types of depression, which can affect people of all ages.
Identifying the symptoms of depression can be difficult. Family, colleagues, or friends are often the first to notice changes in a person's mood or behavior that could be signs of depression.
If you suspect you or someone you know is depressed, it's important to seek treatment and to gain skills for living with depression on a daily basis.
Symptoms of Depression
Depression is more than feeling blue. People with depression experience deep sadness and other emotional, mental, and physical symptoms, including those listed below:
- Loss of energy and enthusiasm, persistent sluggishness
- Inability to concentrate or make decisions
- Significant changes in appetite and sleep patterns
- Irritability, anger, worry, agitation, anxiety, pessimism, indifference
- Feelings of guilt, worthlessness, hopelessness, helplessness
- Loss of enjoyment from once-pleasurable activities
- Prolonged sadness or unexplained crying spells
- Memory loss
- Withdrawal from social contacts, isolation
- Unexplained aches and pains
- Recurring thoughts of death or suicide
Symptoms of depression may range from mild to severe, and may fluctuate over time. Seniors may have different symptoms than other people with depression. Also, they often have other health conditions that can make it more difficult to recognize and treat depression. This is why it's important to see a doctor who has experience treating depression in the elderly, such as a geriatric psychiatrist.
If you suspect someone you know has depression…
If you suspect that someone you care about may be depressed, talk to him or her about it. Gently ask questions, listen carefully, and watch for telltale signs, such as decreased interest in favorite activities.
Recognize that it may be easier for some people to acknowledge physical changes—such as sleep difficulties or loss of appetite—than to talk about feelings like hopelessness. Also, some studies have suggested that men may have more difficulties than women in talking about such problems.
- Do not ignore remarks about suicide; report them to the person's doctor or encourage the person to seek help immediately from a doctor or suicide prevention program.
- Help the person get evaluated and treated; be prepared to accompany him or her to the doctor if necessary.
- Encourage the individual to follow treatment regimens (like taking medication) properly, or to seek different treatment if no improvement is seen.
- Offer emotional support (understanding, patience, affection, and encouragement).
- Reach out to the person—invite her or him to do things; stay in touch with visits and phone calls; and be a good listener.
- Be gentle but persistent in offering help and companionship. People with depression may avoid others or resist offers of help.
- Encourage the person to become involved in activities he or she once enjoyed.
- Do what you can to minimize demands on the person, so that she or he does not feel overwhelmed or inadequate.
Treatment for Depression
When they receive the right therapy, the majority of people with depression can be treated effectively. This improves their quality of life and reduces the risk of suicide and premature death from other medical conditions.
People with depression may need to be treated for a long time—perhaps for life, much like people with diabetes or high blood pressure. Patients older than 75 may respond more slowly to treatment, and may be susceptible to recurring depression.
Types of Treatments
A combination of antidepressant medications and psychotherapy (talk therapy) is often the most effective treatment approach, especially for older persons.
Over time, people with depression may find it's necessary to adjust their treatments. For this reason, they should schedule regular, ongoing consultations with a physician experienced in treating depression in the elderly.
Antidepressants influence the function of neurotransmitters (chemical messengers in the brain). Three major types of antidepressants are available: tricyclic antidepressants; monoamine oxidase inhibitors; and selective serotonin reuptake inhibitors (SSRIs).
Different people respond differently to antidepressants. Finding the one that provides effective relief of symptoms is often a process of trial and error. Sometimes the dose may need to be adjusted, or a combination of medications may be needed.
Antidepressants may take three to four weeks, sometimes longer, before their full effect is felt. If no improvement is seen after several weeks on one medication, another may be tried on the doctor's recommendation.
Psychotherapy is an important part of depression treatment, particularly for older people. The most effective types of psychotherapy for depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).
Administered by a psychiatric professional (usually a psychiatrist or licensed psychotherapist), these therapies can help people:
- Develop strategies for coping with day-to-day challenges
- Learn to counter the negative thoughts and behaviors that accompany depression
- Resolve relationship conflicts that may be contributing to depression
People with short-term depression—such as that associated with medical illness, trauma, or loss of a loved one—may benefit from shorter courses of psychotherapy.
Electroconvulsive Therapy (ECT) remains one of the most effective, yet most stigmatized, treatments for depression. But modern advances in ECT techniques have made this a much safer treatment compared to earlier decades.
ECT stimulates specific parts of the brain with brief low-level electrical impulses, which patients don't consciously feel. Several sessions of ECT may be necessary for full effect. Side effects may include memory loss and other cognitive problems, but they are typically short-lived.
Getting the right treatment is critical. With so many effective treatments available, there is no reason to let depression rob your life of joy. The first step is to take action: see your doctor, ask about treatment options, and follow the therapy prescribed.
Getting Help for Depression
Negative thoughts and feelings—such as exhaustion, worthlessness, helplessness, and hopelessness—that accompany a depressive disorder can make getting help more difficult. It's important to recognize that these are part of the condition, and, if properly treated, will improve.
If you think you may be depressed, talk to your doctor about your concerns. Ask to be screened for depression and discuss possible treatment options.
Sometimes, what may appear to be symptoms of depression may actually be side effects of medications, or may be caused by another illness. Your doctor will want to rule out other possible causes of symptoms, so be sure to communicate what medications you're taking, what other conditions you have, and what is going on in your life that could be affecting your mood.
To diagnose depression, your doctor should perform:
- A physical examination and laboratory tests to rule out other problems
- An interview to elicit details about symptoms, including:
- When they started
- How long they have lasted
- How severe they are
- Whether you have had them before (If so, when? Were they treated? With what?)
- A complete personal and family medical history
- A mental status examination, to identify any effects on speech, memory, or thought patterns
Source: National Institute of Mental Health
Keep in mind that primary care physicians don't often diagnose depression—especially in older persons. You may need to seek help from a specialist, such as a geriatric psychiatrist (a doctor trained to recognize and treat mental illnesses in older people).
Tips for Living with Depression
- Meet with your doctor regularly to assess your health and progress in treating depressive symptoms.
- Set realistic daily goals for yourself, and prioritize your activities.
- Break large tasks down into smaller ones that can be accomplished more readily.
- Don't isolate yourself—get out and socialize with other people.
- Talk with someone about your feelings. This person could be a friend, family member, doctor, professional counselor, or clergy member.
- Try to continue participating in activities that you enjoyed before you began feeling depressed.
- Exercise regularly—studies show it elevates your mood and improves your overall health.
- Give yourself time. Even with treatment, your mood may not improve immediately. You should notice improvement within a few weeks.
- If you can, postpone important decisions until you're feeling better, or discuss matters with someone who might have a helpful or objective point of view.
- Don't be afraid to ask for help, and to accept help when it's offered.
Source: National Institute of Mental Health |
